title: Personalized tuning of a reinforcement learning control algorithm for glucose regulation.
abstract: Artificial pancreas is in the forefront of research towards the automatic insulin infusion for patients with type 1 diabetes. Due to the high inter- and intra-variability of the diabetic population, the need for personalized approaches has been raised. This study presents an adaptive, patient-specific control strategy for glucose regulation based on reinforcement learning and more specifically on the Actor-Critic (AC) learning approach. The control algorithm provides daily updates of the basal rate and insulin-to-carbohydrate (IC) ratio in order to optimize glucose regulation. A method for the automatic and personalized initialization of the control algorithm is designed based on the estimation of the transfer entropy (TE) between insulin and glucose signals. The algorithm has been evaluated in silico in adults, adolescents and children for 10 days. Three scenarios of initialization to i) zero values, ii) random values and iii) TE-based values have been comparatively assessed. The results have shown that when the TE-based initialization is used, the algorithm achieves faster learning with 98%, 90% and 73% in the A+B zones of the Control Variability Grid Analysis for adults, adolescents and children respectively after five days compared to 95%, 78%, 41% for random initialization and 93%, 88%, 41% for zero initial values. Furthermore, in the case of children, the daily Low Blood Glucose Index reduces much faster when the TE-based tuning is applied. The results imply that automatic and personalized tuning based on TE reduces the learning period and improves the overall performance of the AC algorithm.
authors.forename: Elena
authors.initials: E
authors.lastname: Daskalaki
authors.forename: Peter
authors.initials: P
authors.lastname: Diem
authors.forename: Stavroula G
authors.initials: SG
authors.lastname: Mougiakakou
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D001786:Blood Glucose / Q000502:physiology*; D002648:Child; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D019397:Pancreas, Artificial; D057285:Precision Medicine / Q000379:methods*; D012815:Signal Processing, Computer-Assisted
chemical_list: D001786:Blood Glucose; D007328:Insulin